Steroids and social media drug coaches: the changing face of the average NSP visitor

Friday, 22 November, 2024.

Photo courtesy: Unsplash.

In Australia steroids are everywhere. It’s no longer just professional athletes and young men using these drugs to gain an edge, there are hardstyle ravers jumping on the juice train, women, office workers, school teachers and even cops.

As the legacies of human hulks like Arnold Schwarzenegger and Zyzz snowball, it seems more and more people want to carve out a chiselled 6 pack and build lats the size of an eagle’s wingspan. Online forums and social media are brimming with harm reduction advice for performance-enhancing drugs.

The topic is even becoming a part of academic conferences, in large part thanks to the pioneering work of the Australian peer researcher Dr Tim Piatkowski. In fact, discussion of steroids seems to be happening everywhere except at medical centres and gyms, due to the strict laws around illegal steroid use across Australia. Doctors aren’t always understanding. It makes finding reliable sources of information a tad more difficult.

If you’re wondering where you should look for information, where you should pick up clean injecting equipment and who you can talk to about your steroid use, you’re in the right place. This isn’t a harm reduction resource for those at the point of injecting regularly (for that, sus this previous Users News story). No, this is a resource for those a little earlier in their drug journey: a guide to social media drug coaches, online gym trainers and needle exchanges.

What exactly are steroids?

Anabolic steroids, aka roids or juice, are a group of substances that copy the effects of testosterone, a hormone. People use them to build muscle mass and body strength. Some use them to gain an edge in amateur or professional sport (doping) while others use them simply to look good.

There are other steroids out there but the drugs we’re discussing in this article are called anabolic steroids. They’re a prescription-only medication and there’s also a huge black market for them. They come as tablets, capsules, oral liquids and injectable liquids.

Anabolic steroids are part of a broader group commonly labelled “PIEDs” or “performance and image-enhancing drugs”. This term includes other substances such as melanotans (peptides for tanning and weight loss) and the weight loss drug Ozempic (commonly injected).

Roid use is on the rise

“Why is everyone on steroids now?”, GQ declared in June this year. Statements like this from the world’s most iconic men’s magazine tend to have cultural weight. Sure, GQ may not be the first to pick up on global trends but it does reflect them.

Moreover, data seems to confirm the claim. According to the Australian Criminal Intelligence Commission, the weight of steroids seized at the border increased 1372% between 2011 and 2021. The latest Australian NSP Survey National Data Report, meanwhile, suggests steroid use is on the rise. Collecting responses from almost 2000 visitors to needle and syringe programs (NSPs) across Australia, the report found that the percentage of respondents who had last injected PIEDs had increased from 4% in 2018 to 7% in 2022. According to the Kirby Institute, the number of NSP visitors in NSW who had last injected PIEDs jumped from 13% in 2019 to 23% in 2023. It’s an even bigger jump than the national average!

A surging proportion of people visiting NSPs for PIEDs-related needs and police seizures doesn’t necessarily mean that more people are using these drugs. But it’s certainly a strong hint that this is the case.

Moreover, staff at NUAA’s Crown Street NSP in Surry Hills tell Users News that anecdotally the number of visitors coming in to chat about PIEDs has risen in recent years. “There isn’t a week in the year where we’re not providing equipment to people using PIEDs,” NSP manager Nikkas Skelley says. “Some days it feels like we’re helping PIEDs users more than other people who inject drugs, especially in the warmer month.”

Peer knowledge is the way forward

Dr Tim Piatkowski talking at NUAA’s 2024 Peers and Consumers (PaC) Forum. 

Dr Tim Piatkowski’s work and way of doing research is very rare in the academic world. He love pumping iron and has experimented heaps with steroids, and he writes all about it. He’s an academic who is open about his drug usage, a taboo topic within the sandstone walls and hallways of Australian unis. It’s also a bold step considering the harsh prison sentences for steroid possession and supply across Australia.

Dr Tim Piatkowski told Users News that valuing peer knowledge is really important. For some popular steroids what little scientific research there is has largely involved experiments with lab rats. Trenbolone or “tren”, as it’s commonly called, is one example. It’s a livestock drug used to put lean muscle mass on cattle.

Tim recently led a pioneering study on the psychological and health effects of taking tren in which he drew on his own involvement in the bodybuilding scene. A YouTube star and performance-enhancing drugs educator called Vigorous Steve then made a widely-shared video dissecting the academic paper. The pair are now collaborating and producing social media content together which neatly sums up how knowledge spreads in these communities.

“The knowledge of some people using steroids is exceptionally deep. It can exceed many people’s knowledge in the health workforce,” Tim explains. “They self-experiment, exchange knowledge, read up.”

Contrary to stigmatising mainstream media narratives of steroid users as tattooed bikies and juiced-up thugs, Australia’s steroid-using communities are notable for their diversity. Indeed, some observers have noted an especially welcoming attitude towards trans people in steroid communities due to a shared belief in an individual’s right to alter their body with hormones.

“Community care is really big for this group for people”, Tim says.

He does warn, however, that, while intentions are “usually well-meaning”, this doesn’t always mean every gym influencer is well-equipped with knowledge.

Navigating online forums: What to watch out for

To source illegal steroids and learn how to use them, you once had to enter the bodybuilding inner sanctum. You had to be a known face in the gym, a trusted confidante. In the last 10-20 years, however, all that has changed. Instagram, Youtube and “GymTok” are awash with drug coaches, firsthand reports on different steroids and juice sellers. Roids are available with the click of a mouse. So you need to know how to sift the gold from the bullshit.

While they’re certainly in the minority, you will find some snake oil salesmen skirting the edges of these spaces.

We must recognise that we live in a time of telehealth where alternative medicines are on the rise, the wellness industry is expanding, faith in the traditional medical establishment is eroding and once-taboo drugs are becoming more mainstream. Anti-vax perspectives and QAnon legions are growing online while the wellness industry bombards us with advertising telling us we can always look better. We can even stop the ageing process if we buy the right products or drugs. Apparently. Much of this cosmetics advertising is wrapped up in language around self-care, spiritualism and being one with nature. But, like any other businesses, the wellness industry is about dollars. In fact, it’s rife with false advertising and claims without proven scientific basis.

“There’s some people in the community that are just outright financially motivated either because they’re supplying product or because they are building a name as a coach,” Tim says. “It’s a big red flag if someone online goes ‘oh, there’s no point doing less than X amount of this drug because you won’t see results’. I’ve seen it a few times – a lot of times actually. This immediately stands out to me as not evidence-based. Any amount that you put in your body is going to have an effect, and there’s a ceiling eventually and diminishing returns. You’ve got to balance how much the drugs shut you down versus the benefits.”

What the online steroid scene needs is transparency so people don’t get confused if they aren’t seeing the gains they’re expecting. This only perpetuates negative body image. But this issue is also bigger than just the steroid community, Tim explains. The way the public converses around drugs needs to change.

“Open discussions can’t just be in steroid forums and these little information pockets online. The approach needs to be: OK people like looking good. They use drugs to make it happen quicker. So let’s talk about safer ways to use these drugs.”

The harm reduction green flags in cyberspace

A good place to start for entry-level knowledge is The Juice, a website set up by the Australian Injecting and Illicit Drug Users League (AIVL) for people who use PIEDs. Tim also recommends Hi-Ground, an online community hub with harm reduction resources and chat rooms.

Here’s some more of Tim’s recommendations:

• Vigorous Steve
• Kayden Weller
• The Lifters League Podcast hosted by Gus Cooke and Ruby Cooke.

Detailed steroid logs, documenting 12-week cycles, are “a big green flag”, Tim says. (People usually take steroids in cycles so they don’t develop a high tolerance. This practice also limits unwanted side effects and allow the body’s natural testosterone production to resume.)

Experienced community members who ask questions rather than offering definitive answers, and encourage young people to establish a strong fitness foundation before turning to the juice, are another green flag. Is your diet in check? Is your lifting good? How’s your technique? Is your mind in the right place? These are the kinds of questions you want to hear and read from peers. This may not be traditional harm reduction advice, which usually centres around accepting that prohibition doesn’t deter drug consumption, but PIEDs aren’t just any drug.

Taking steroids for the first time is a really big step. Steroids come with a range of long-term side effects which aren’t well researched. It’s also tricky to come off them suddenly. While you may feel like you’re mainlining the universe during the initial intake period – many report feeling more confident, more motivated and more sexually aroused – steroids are linked to low testosterone levels in the long-term. Once reliant on roids, your body struggles to reproduce testosterone. So it’s really important you dive deep into the research and chat to people with lived experience before injecting steroids for the first time.

Tren, for instance, which is widely considered one of the most hardcore steroids, can cause acne, so-called “tren cough” and changes in mood, such as irritability, impulsivity and heightened aggression. It can also limit cardiovascular fitness (essentially how long you can run, swim, cycle or play sport for).

The changing face of the average NSP visitor

Tim warns that doctors aren’t always the best when it comes to steroid knowledge and advice but “the landscape is changing a little”. GPs are usually happy to conduct health checks for anabolic steroid users and to let people make their own (informed) decisions free of hassle, but they’re still hesitant to prescribe the drugs. If you want to go to a testosterone replacement therapy (TRT) clinic, another alternative, there are very real financial barriers. You’ll face expensive consultation fees and frequent visits for blood tests. Furthermore, you’ll find a bunch of dodgy vendors and scam private clinics offering TRT so some level of caution is warranted. These suspect clinics tend to disappear quickly as a result of failures to follow standard procedures. Many people therefore turn to the black market.

It's important to remember, however, that there are reliable brick-and-mortar services that can help you. They’re called needle and syringe programs or NSPs. It’s well worth visiting an NSP for clean equipment and advice.

If you’re injecting steroids, you face the same health risks as other injecting-drug users. Unsterile or re-used sharps can spread blood-borne viruses such as hepatitis C and HIV/AIDS. While using steroids typically involves intramuscular injections, rather than injections straight into your veins, which is what people do for a hit of, say, heroin or shard, you can still easily get a bloodborne virus from an intramuscular injection.

There’s not always a lot of overlap between communities of people who inject heroin and ice and those who inject steroids but more and more PIEDs users are visiting NSPs and realising these services are meant for them too.

Nikkas from NUAA’s Surry Hills NSP says, “we know when someone hasn’t had medical access or hasn’t researched their needs, as they are not quite sure of the equipment that they need. They might come in with a photo of the equipment or a list for us to fill, which then opens the conversation on researching what you are taking from reputable sources, having ownership over your body and your injecting practices and the empowerment that provides. There’s no shame in feeling a bit at sea at first.”

“We provide education around bloodborne viruses for people who use PIEDs,” Nikkas continues. “There are a range of risk factors they might not be aware of: infections from not using the correct length or gauge of equipment, not swabbing after injection, only before injection. Swabs contain alcohol which encourages an open wound to bleed and this can leave bruising (blood under the skin). Knowledge is empowerment. The more you know the better informed choices you can make.”

We know that some steroid users choose to buy injecting equipment online. Some don’t like to associate with NSPs due to stigma towards heroin and ice users. Nikkas reports that a small number of PIEDs users have brought their own prejudices into the service, claiming they don’t inject (illicit) drugs and calling 1 millimetre syringes “junkie needles”. We call this discrimination by an already stigmatised and criminalised community towards another similar community “lateral stigma and discrimination”.

Nobody should be judged for how they choose to take drugs and which drugs they prefer. Plus, the initiative and DIY spirt of those same injecting drug users are the reason Australia stood out in the 80s as a truly pioneering nation for the dispersal of clean injecting equipment and harm reduction education. They’re the reason we are where we are today.

It’s important to note at this point that there are some steroid knowledge gaps among staff at NSPs because these services have traditionally focused on people injecting heroin and ice. But this is all changing quickly and workers in the sectors are making a determined effort to upskill.

As Nikkas explains, “we know what equipment is needed, safe injection methods, how to prevent bloodborne viruses and so on. But when it comes to the different types of anabolic steroids and peptides we only have a basic understanding. This information doesn’t roll off our tongues as easily, so to speak.”

NSPs will help you with the equipment and injecting practice side of things but if you’re looking for really specific advice about particular steroids it’s important to trawl those online forums and learn up.

If there’s a common theme in this article, it’s that you need to do your research before jumping on the roid train. If you don’t know what you’re doing, you could face serious health problems, both mentally and physically. We’re not saying you shouldn’t do it. It can certainly be done properly. Just proceed with caution.